Employee Green Behavior in Hospitals: A Scoping Review of Definitions and Influencing Factors

Background: Employee green behavior (EGB) refers to environmentally responsible actions undertaken by employees in the workplace. Although interest in EGB is growing, hospitals represent a uniquely complex environment where clinical demands, operational constraints, and regulatory pressures may shape such behavior in distinct ways. To date, no review has synthesized literature on EGB within hospital settings. This scoping review synthesizes existing research to clarify how EGB has been conceptualized and studied in hospitals, identify factors associated with EGB, and inform future research and sustainability efforts in healthcare organizations. Methods: This scoping review followed the Joanna Briggs Institute (JBI) methodology and reported per Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines. Seven databases (PubMed, CINAHL, Embase, Web of Science, Scopus, APA PsycINFO, and Emerald) and grey literature were searched from inception to January 31, 2025. Studies examining EGB among hospital employees were included. Results: Twenty-three studies met the inclusion criteria, with most published after 2021. The majority employed quantitative survey designs and focused on nurses, although some included multidisciplinary staff. Considerable variation was observed in how EGB was defined and measured across studies. Factors reported in relation to EGB were organized into four levels: individual, team, leadership, and organizational. Qualitative findings highlighted barriers such as time constraints, insufficient training, limited knowledge, and lack of leadership support, as well as facilitators including individual motivation, environmental awareness, shared responsibility, and access to sustainability resources and education. Conclusion: EGB in hospital settings has been defined and examined inconsistently in the existing literature. This review proposes a working definition of EGB as employee actions in the workplace that minimize environmental harm and promote sustainability. The findings indicate that EGB in hospitals is influenced by multiple factors, and effective sustainability efforts in healthcare organizations require coordinated multilevel approaches. Registry Name and Number: The review protocol was registered with the Open Science Framework (osf.io/kd57r).